In Florida, economy is key, but health care counts

BRADENTON, Fla. – Four years after falling for hope and change, Kevin Mann now worries that a changing health care system will stop small businesses from growing.“It’s scary if you want to expand your business and then will have to start offering health care” to employees, said Mann, a Buffalo-area native who now runs the Casa Di Pizza outlet in this Gulf Coast community. “It would definitely take a lot of money out of the bottom line.”But 45 miles to the north in Tampa, Denise Travers already enjoys some of the benefits of the bill that Republicans derisively and Democrats proudly call Obamacare.“My daughter would not have health insurance without this law,” said Travers, formerly of East Amherst, who put her daughter Kelly, 23, on her health insurance policy as permitted under the Obama health law. “And there are so many people in that boat.”You’ll find plenty of voters like Mann, and Travers, here in the Sunshine State.And that helps explain why Florida remains among the swingiest of swing states, with Republican Mitt Romney now holding a narrow lead in the polls similar to the one President Obama held only two weeks ago.While the economy is the key issue here as it is everywhere, interviews with voters from across the state show that the landmark health law that Obama signed in March 2010 – which Romney wants to repeal – is on the minds of many Floridians as well.And it’s because, hate it or love it, the Obama health reform law is so intimately tied to the bottom line of the nation and its voters....Mann and Travers are proof of that.Mann’s business doesn’t come close to the 50-employee threshold at which small businesses will have to start offering health insurance on Jan. 1, 2014, but that fact alone isn’t enough to stop him from worrying.Even though the bill calls for tax credits that will help small businesses pay for insurance, Mann thinks the health law could be a dead weight on the economy, stopping small businesses from hiring to make sure they stay under that threshold.And with all the government involvement and a mandate that all Americans buy health insurance, “we’re going to have to pay more if we need health care,” said Mann, 37, who voted for Obama in 2008 only to become frustrated with the president’s performance on the economy and his focus on health care reform.But Travers isn’t frustrated at all.“I support our president,” said Travers, 47, a market researcher. “I think he is doing the best he can with a difficult situation. We were in a big mess when he started, but it’s much better now.”What’s more, the American health care system is much better now, Travers said. Not only does the bill allow people to keep their children on their health insurance policies up to the age of 26, Travers said it brings something new and important to the American health care system: fairness.“I don’t think your health care should depend on who you work for or what you can afford to pay or who your spouse is,” Travers said. “Everyone should be able to get good, quality health care.”...That’s the aim of the Obama health law, which will require virtually all Americans to have health insurance – either through their employer, through the government or on their own – starting in 2014.The health law vastly expands the Medicaid system to offer health care to the working poor who otherwise could not afford it. But it will force some people to either pay for their own health care or pay a penalty.That “individual mandate” is the heart of the Obama health law – and voters such as Jay Plachta wish they could rip that heart out.“I’m fairly healthy, so I figured I might as well just pay for my health care as I go along,” said Plachta, 45, a Buffalo native who now runs JP Financial Wealth Consultants near Jacksonville. “I don’t want to buy health insurance but I’m going to be forced to pay for it anyway. The fact that the government would slap a mandate on us like this just blows my mind.”To Obama and his supporters, though, the health care mandate is simple common sense. Without the mandate, millions of Americans would continue to rely on expensive emergency room care and never get the cost-effective preventive care that the bill encourages.Voters such as Scott Kollig said they see health care reform as a historic accomplishment that eluded several presidents over a century until Obama came along.“It wasn’t just the right thing to do; it was his push that got it through,” said Kollig, 22, a Clarence native working at Cafe Boulud, a Palm Beach restaurant....Yet for every Scott Kollig in Florida, it seems that there’s a Bob Daniels.“I hate it. I know it’s not going to work,” Daniels said of the health care law.Daniels speaks from experience. A former employee benefits manager at National Fuel in Buffalo, he worries that the bill will drive up demand for health care and drive up costs. Meanwhile, things that could have helped control health costs – such as medical malpractice reform and allowing insurers to sell policies across state lines – were left out of the Obama health law, noted Daniels, who now lives in The Villages, a heavily Republican retirement community in central Florida.“He’s destroying the country,” Daniels, 67, said of Obama. “There’s way too much government.”And for every Bob Daniels, there’s an Andy Tramont.A Miami lawyer who’s originally from Clarence, Tramont, 58, praises the Obama health law for barring insurers from discriminating against people with pre-existing medical conditions.“I’m a Democrat and a liberal and I think part of what government should do is to take care of those who can’t take care of themselves,” Tramont said....Tramont also worries about Republican proposals to remake Medicare, the government-run health care system for seniors, into a voucher system, where future seniors would get a set amount from the government and then shop around for health care.He thinks such a program could foist more health care costs onto seniors who can’t afford it – and he’s not alone.“I know that they’re saying that this is not going to take effect right away, that it will only affect people 55 and younger,” said Martie Krone, 62, who lives in The Villages with her husband, Bill, a retired principal at Williamsville North High School. “But all the extra costs are really going to hurt people on Medicare.”Still, her husband, 61, said he knows the government has to do something to control the costs of Medicare and Social Security as the baby boomer generation ages, lest the programs’ costs spin out of control.Bill Krone suggested means-testing for Medicare and Social Security – in other words, making the wealthy pay more for them.But plenty of Florida seniors also agree with Tom Nuthall, 66, a Buffalo native now living in Titusville, on the “Space Coast” east of Orlando.Given the fact that the Medicare trust fund is on target to be insolvent by 2024, Nuthall sees no problem with reforming the program now for future retirees.“To have people younger than 55 prepare for these changes now while they are still working seems to me to be a fair thing to do,” said Nuthall, 66, a retired general contractor who complains that Obama has driven the nation into “two separatist camps.”...The Sunshine State seems to be that on the surface, but on further inspection, it’s much more complicated.“Florida is a lot of different pockets of voters,” said Terri Fine, an Amherst native who’s now a professor of political science at the University of Central Florida in Orlando.The state is home to a large military community, as well as many evangelicals. Its huge Hispanic community is split, with Cuban-Americans favoring Republicans and others leaning toward Democrats. Seniors are divided, too, with the wealthy lining up with the GOP and others going Democratic.“To get votes here, you have to appeal to all the different pockets,” Fine said.Still, the sharp partisan division in the state reflects that of the nation at large, and it means that the state’s politics doesn’t quite shake out as you might assume.For example, while Democratic attacks on GOP plans to reform Medicare have won votes in Western New York and the rest of the nation, it’s proved to be a much less effective message here.“Among Florida seniors, 42 percent are Republican and 41 percent are Democrats,” said Susan MacManus, distinguished professor of political science at the University of South Florida in Tampa. “They’re not going to be abandoning their party” just because of the other party’s attack ads on the Medicare issue....Still, Romney and Obama can’t seem to stop trying to turn the health care issue to their favor in Florida.Noting that the Obama health law cuts $716 billion in subsidies to Medicare providers, Romney told a crowd in Port St. Lucie last week that will mean “$44 billion of cuts right here in Florida.”Romney has also said he wants to repeal Obamacare and its individual mandate while retaining some of the law’s most popular provisions, such as the one allowing young people to stay on their parents’ policies. He also would maintain the ban on discrimination against those with pre-existing conditions, but only for those who already have insurance.Obama, meanwhile, wants to stay the course on health care reform.“We passed health care reform so that your insurance companies can’t jerk you around anymore, or tell you that being a woman is somehow a pre-existing condition,” he told a crowd at the University of Miami last week.No matter who wins, health care reform is likely to move forward in some form, said Michael W. Cropp, president and CEO of Independent Health of Buffalo.If Romney wins, the individual mandate may die, but the popular parts of Obamacare will likely stand, and medical malpractice reform may finally become a reality, Cropp said.And if Obama wins, there may be delays in the health law’s implementation, Cropp said, but it will move forward in total.Whether that happens depends on how many swing state voters agree with Joyce Dees, and how many agree with Angie Barnini.Dees, a 78-year-old retiree from Tampa, thinks Obama is “brilliant.”“Have the last four years been all that great? No,” she said. “Could anyone have done better? No.”Meanwhile, Barnini, 52, is leaning toward Romney after his “commanding” debate performance, even though she wishes he would be more specific on the issues.As for Obama, she said: “I think he’s a great man, but I don’t think he’s accomplished a lot.”And what he’s accomplished scares Barnini, a Rockledge, Fla., resident who worries that Obama administration cuts to the space program could affect her husband’s job. She also worries that the health care law will encourage her husband’s employer to drop its health care plan.Echoing many Florida voters, she asked: “Will we be paying more out of our pockets?”